Reactions 1444 - 23 Mar 2013

SFlecainide

Neutropenia in an elderly patient: case reportA 73-year-old woman developed neutropenia following

treatment with flecainide for atrial fibrillation.The woman was hospitalised after experiencing a transient

ischaemic attack; she had a history of hepatitis B infection. Itwas revealed that for the last 3 months she was receivingflecainide 50mg twice daily [route not stated] for atrialfibrillation in place of metoprolol. Tests performed onadmission showed a WBC count of 2.5 × 109/L and aneutrophil count of 0.61 × 109/L; reactive lymphocytes werealso noted. A reduced platelet count and normal haemoglobinvalues were reported with an increased mean cell volume.Tests revealed a CRP value of 15 mg/L with an ESR value of19 mm/hour. Repeat tests performed on admission day 2showed a neutrophil count of 0.28 × 109/L.

Flecainide was withdrawn; five days later, the woman’sneutrophil reached 1.59 × 109/L. Metoprolol was reinitiated.

Author comment: "There was a probable causalassociation between flecainide and neutropenia."Forbes M, et al. Medicinal mishap: Flecainide and neutropenia. AustralianPrescriber 36: 17, No. 1, Feb 2013 - Australia 803084864

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Reactions 23 Mar 2013 No. 14440114-9954/10/1444-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved